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VIENGKEO CHANTHALOTH- PHASOUK, LCSW
LCSW
Clinical Social Worker
NPI: 1366920811IndividualAccepts Medicare
Specialties, Licenses & Credentials
Counselor
Counselor
Code: 101Y00000X
Clinical Social WorkerPrimary
Social Worker — Clinical
Code: 1041C0700X
149.022418(IL)
CMS Specialties
PrimaryCLINICAL SOCIAL WORKER
Education
OTHER
Class of 2014
Contact & Hours
- Address
- 2704 N MAIN ST
ROCKFORD, IL 61103 - Phone
- (815) 391-1000
Quick Facts
- NPI
- 1366920811
- Entity Type
- Individual
- Gender
- Female
- Medicare
- Accepted
- Specialties
- 2
- Locations
- 1
- Years in Practice
- 12
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